Cultural adaptation and psychometric evaluation of the Norwegian version of the neonatal eating assessment tool

OBJECTIVE: Preterm infants experience feeding difficulties that may persist beyond infancy and affect both infants and their families. The Neonatal Eating Assessment Tool (NeoEAT) is a parent-reported questionnaire designed to identify feeding difficulties in infants across breastfeeding, bottle-feeding, and mixed-feeding modes. This study aimed to translate and culturally adapt the NeoEAT into Norwegian, evaluate its psychometric properties and explore parent-reported feeding difficulties among Norwegian infants. METHODS: The NeoEAT was translated and culturally adapted according to the ISPOR Principles of Good Practice for Translation and Cultural Adaptation. In a survey study, parents of preterm and term infants completed the Norwegian NeoEAT, which was used to assess internal consistency, test-retest reliability and known-group validity. RESULTS: Fifty parents participated in the survey. Cognitive debriefings supported the face validity of the Norwegian NeoEAT. The questionnaire demonstrated strong internal consistency for the total scales (Cronbach's α = 0.85-0.90) and good test-retest reliability. However, several subscales showed low internal consistency and known-group validity was limited. Parent-reported feeding difficulties were similar in preterm and term infants, although some differences were observed in the breastfeeding version. CONCLUSION: The Norwegian NeoEAT was successfully translated and culturally adapted. The findings support its face validity, internal consistency, and test-retest reliability. However, limitations related to sample size and construct validity indicate that the present study should be regarded as a preliminary psychometric evaluation rather than a full validation. Further studies with larger and more diverse samples are needed to establish reference values and confirm the instrument's psychometric properties.